TCP/IP optimization over wide area networks: implications for teleradiology

Area of Science:

• Medical Imaging
• Network Engineering
• Radiology Informatics

Background:

• Radiology studies generate large datasets, with increasing volume due to advanced imaging techniques.
• Picture Archiving and Communication Systems (PACS) traditionally rely on fast local area networks (LANs) for efficient image retrieval.
• Teleradiology solutions often use a push model to overcome wide area network (WAN) limitations like high latency and moderate bandwidth.

Purpose of the Study:

• To develop a PACS environment that provides a local-like experience for image retrieval over a long-distance WAN.
• To address the performance challenges of transferring large radiology image files across a 3,000-mile WAN link.

Main Methods:

• Investigated and implemented various strategies over 16 months to optimize WAN performance for PACS image transfer.
• Compared image retrieval speeds between the optimized WAN and a standard LAN.

Main Results:

• Initial testing revealed WAN performance was 30 times slower than LAN performance.
• Through extensive optimization efforts, the WAN performance was improved to be only 1.5 times slower than the LAN.

Conclusions:

• Significant improvements in WAN performance for PACS are achievable, reducing the disparity between local and remote access speeds.
• The findings support the feasibility of creating responsive teleradiology systems even across geographically challenging network links.